Abstract: Objective To assess the assess the utility of the Nottingham Hip Fracture Score(NHFS) as a predictor of postoperative complications in elderly patients undergoing hip surgery.
Methods NHFS was retrospectively calculated for 820 patients who had undergone hip fracture surgery between January 1st 2016 and November 30th 2019.Patients’ gender,age,height,weight,Body Mass Index,ASA class,fracture type,type of surgery and anesthesia,postoperative visual analogue score,intraoperative blood loss and urine output,history of blood transfusion,history of dementia,preoperative hospital stay,postoperative hospital stay,length of hospital stay,admission to ICU,preoperative coexistent diseases,and postoperative complications were compared.According to the NHFS,patients were divided into two groups:NHFS≤5 scores group and NHFS>5 scores group.
Results Compared with patients in NHFS≤5 scores group,the patients with NHFS>5 scores group showed significantly higher age and ASA class,lower BMI,and larger proportion of subcephalic fracture and combined spinal-epidural anesthesia(P＜0.05).There were significant differences in postoperative anemia,deep vein thrombosis(DVT),delirium,arrhythmia,pulmonary infection,cerebral infarction,electrolyte disturbance,hypoxemia,renal dysfunction,heart failure,and admission to ICU between the two groups(P＜0.05).
Conclusion Postoperative complications are more likely to occur in patients with higher NHFS,which might delay the hospital length of stay with poor total outcome.The NHFS is a reliable tool for predicting prognosis.It may be useful for discharge planning,and for the design of future research trials.

Key words: Nottingham hip fracture score, elderly, hip fracture, outcome